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3400 Auto Plaza Way. Record ID# PR0514278 <br /> 11/3/2020 Program: HW <br /> Photo 7: The following uniform hazardous waste manifest(018531274JJK) observed lacking signed copy. <br /> Prpase print or We.(Famr designed for use on else(12-ptdr)TVpm ,h Form Appmved,C109 No 235o W19 <br /> it UNIFORM HAZAR70uS t Gene am r0 Numbe 2 Page 1 1._3.E,—rgeng Beep .Phone 4 M mat T ddag N.H., <br /> U=M <br /> MANIFEST 7 M1rn.^Y1r q 2.1!l:t{ifJ �19531.27'�'� JJK <br /> 5 Gane^afi's Name ane I.taJmg Aednse Gerbrabre Siy rias til metres.tan marMgederesa7 A;1 <br /> A fir;-r v L <br /> GenaralcraPFcrra = ;�:'3 ! <br /> 5TranepMerl CmnWnY rxnro US.FPAIU ylwnbw ..: $• y <br /> WOfM O eN[FNVIRONRIENTAL FIFFMCC9 C A D O 7 N 2 T l O? I:'�'$ i �L dr ill lqqj lbw• S <br /> 7 Transporter F Ge AY Name U.S EPA In Numbs <br /> a Geslgnated Fe Irly Name end Silt ddfeae US EPA IG Number <br /> YF'9 NWNAGEMENT.INC <br /> 670(7115 HIGHWAY 95 <br /> '(WAA e:A 11,385 <br /> Fatah a Pfione: i 9.28)344-982A r•-.'4'.U V U a 2 1 14 6 <br /> ga 9b.➢S.UOT eascnpllen tlntluang Proper SnWpr9 Nama.Reared Ciao,IG Number, 10.Comtainam 11.TOW 12.Urn t34Jea18 Cotlee <br /> HM end PeWng Gmup[f e^Y11 No. TYpa CNanVly WUYG. <br /> 1NON.RCRA HAYARI70U8 WA8TE.90L1D((ALY GOLI6 PAPER FILTER ) - <br /> o - <br /> z z <br /> A7 <br /> 3 <br /> -� suya,P,�,AsvwAr�- <br /> 4 'A/7TSjB- STF R <br /> - g.SOL V�T�. <br /> 74,Spoia H rd ing Insauobons and Addaional Infomradon <br /> EMERGENCY CONTACT CNEMTREC 1806424-9300 WOES TrRMINAL •PROFILER 461 OS-PF CERFS 'ADDITKNUU.EPR <br /> CQOES 981 NONE a APPROPRIATE PER^OW,PROTECTIVF EQUIPMENT - --; <br /> 15. �GENERATOR',S1OFFEROR'$•S1OFFEROR'S CENTIFICATION:I hereby dedare Mal the content ofthls consignment are lusty and a curatefy described abme by the proper ahlppng narcre.and 8+ tassied,packaged, <br /> balaVpfacarded,andaremallrespectsinpropefconditionfortransponaccordingtoapplicableIntemationeiandnationalgmemme Wmgulatprtsy that NemnlentsolMIsmnsigamentconformtothetermsofdnaattached EPA Acknowledgment of consent. <br /> waste minimization sMlemanl idendfed in 40 CFR 262.2)fal(iF am a large quandry generals}or(b1 @fl am a smalV quanury generator}is Vue,GenePnn� ylaed Name Signature Monts Day Year —•-� <br /> 1'6.Intama9ona!shrpments ❑IMW to U.S. ❑E,.Anrom u.s. Port of entryrexit <br /> _/ T2nspoder signature florexpons onlyl: Date 6­1,g 1,g U.S.. <br /> �—l t7 TransporterAdmwAedgmeM of Reeeip of Malatials -__ <br /> -� w elute Monty Day Yean <br /> � Transporter 1 PdntedlTyped Name Sign <br /> a <br /> i 7ransporter2 PnnleVyped Name SignalLne Monty ➢ay Year -. <br /> ON rq <br /> ,NRC E g1N <br /> S <br /> 4r 18.Discrepancy <br /> I 18a_Dlscrepancylndiratwn Space ❑Quanmv ❑Type ❑Rosldue ❑Pa+Oat Rejection ❑F01 Releaion <br /> 1 Manilesl ftalerance Numoer. <br /> 198.AHemate Fanfily(cr Generator) us.EPA I➢Number <br /> 1 <br /> V <br /> Cn Faciliya Phone:W 18c,Signature olklemato Facility for Generator) Month Day Year ■Yn_ <br /> 4 <br /> Z <br /> 19.Hazardou5 Waste Report Management Method Codes(i a,codas for hazardous waste treatment,disposal,end 115cyclirre systems) <br /> 2. 4. <br /> D 1' <br /> 3. <br /> 10,Designated Faciirty 0wneror operator:Cerv6ntton of receipt of hazardous materials covered by the manifest axoepl as noted In Item 188 <br /> Pnnledlrypt#Name gnature MW& Day Year <br /> EPA Form 8700.22(Rev.3-05)Previous editions are obsolete. GENERATOR'S NITIAL COPY <br /> JASON GAITAN, REHS Page 7 of 48 <br />